Cognitive Avoidance Is Associated with Decreased Brain Responsiveness to Threat Distractors under High Perceptual Load.

Cognitive coping strategies to deal with anxiety-provoking events have an impact on mental and physical health. Dispositional vigilance is characterized by an increased analysis of the threatening environment, whereas cognitive avoidance comprises strategies to inhibit threat processing. To date, functional neuroimaging studies on the neural underpinnings of these coping styles are scarce and have revealed discrepant findings. In the present study, we examined automatic brain responsiveness as a function of coping styles using functional magnetic resonance imaging. We administered a perceptual load paradigm with contemptuous and fearful faces as distractor stimuli in a sample of N = 43 healthy participants. The Mainz Coping Inventory was used to assess cognitive avoidance and vigilance. An association of cognitive avoidance with reduced contempt and fear processing under high perceptual load was observed in a widespread network including the amygdala, thalamus, cingulate gyrus, insula, and frontal, parietal, temporal, and occipital areas. Our findings indicate that the dispositional tendency to divert one's attention away from distressing stimuli is a valuable predictor of diminished automatic neural responses to threat in several cortical and subcortical areas. A reduced processing in brain regions involved in emotion perception and attention might indicate a potential threat resilience associated with cognitive avoidance.

Non-conscious processing of fear faces: a function of the implicit self-concept of anxiety.

BACKGROUND: Trait anxiety refers to a stable tendency to experience fears and worries across many situations. High trait anxiety is a vulnerability factor for the development of psychopathologies. Self-reported trait anxiety appears to be associated with an automatic processing advantage for threat-related information. Self-report measures assess aspects of the explicit self-concept of anxiety. Indirect measures can tap into the implicit self-concept of anxiety. METHODS: We examined automatic brain responsiveness to non-conscious threat as a function of trait anxiety using functional magnetic resonance imaging. Besides a self-report instrument, we administered the Implicit Association Test (IAT) to assess anxiety. We used a gender-decision paradigm presenting brief (17 ms) and backward-masked facial expressions depicting disgust and fear. RESULTS: Explicit trait anxiety was not associated with brain responsiveness to non-conscious threat. However, a relation of the implicit self-concept of anxiety with masked fear processing in the thalamus, precentral gyrus, and lateral prefrontal cortex was observed. CONCLUSIONS: We provide evidence that a measure of the implicit self-concept of anxiety is a valuable predictor of automatic neural responses to threat in cortical and subcortical areas. Hence, implicit anxiety measures could be a useful addition to explicit instruments. Our data support the notion that the thalamus may constitute an important neural substrate in biased non-conscious processing in anxiety.

Coping With Anxiety: Brain Structural Correlates of Vigilance and Cognitive Avoidance.

Background: Individuals differ in their dispositional coping behavior when they are confronted with anxiety-provoking situations. Cognitive avoidance is characterized by a withdrawal from threatening information, whereas vigilance denotes the intensive search for threat-related information. Functional neuroimaging studies indicate alterations in brain responsivity to emotional stimuli as a function of cognitive avoidant and vigilant coping, but findings are partially discrepant. Studies on structural correlates of coping styles are scarce. Materials and Methods: By using structural magnetic resonance imaging, the present study examined the relationship between brain gray matter volume and coping strategies in 114 healthy individuals. Individual differences in vigilance and cognitive avoidance were measured by the Mainz Coping Inventory. Results: Exploratory whole-brain analyses were conducted. Cognitive avoidant coping significantly predicted reduced gray matter volume in the bilateral thalamus, whereas vigilant coping was associated with volumetric increases in the bilateral thalamus. These relationships remained significant when controlling for a potential influence of age, sex, depressive symptoms, and trait anxiety. Discussion: Our findings indicate that dispositional strategies to deal with anxiety-provoking situations are related to volumetric alterations in the thalamus, a brain structure that has been implicated in the mediation of attentional processes and alertness, and the anticipation of harm. The dispositional tendency to monitor the environment for potential threats (i.e., vigilance), appears to be associated with volumetric increases in the thalamus, whereas the dispositional inclination to divert one's attention away from distressing stimuli (i.e., cognitive avoidance) seems to go along with reductions in thalamic gray matter density.

Utilization of e-mental-health and online self-management interventions of patients with mental disorders-A cross-sectional analysis.

BACKGROUND: Web-based treatments and online self-management interventions extend the range of therapeutic supply. Since the number of online self-management interventions is steadily increasing, we aimed to examine, how web-based services currently influence mental health care, asking about previous internet use and future interests of patients with mental disorders. METHODS: We consulted patients (n = 400) from all services of the Department of Psychiatry and Psychotherapy of the University of Leipzig using a 28-item questionnaire. Overall, 301 questionnaires could be used for analysis. The data were analysed by means of descriptive statistics and group comparisons. RESULTS: The majority of patients (98.3%) were using the internet. Data revealed younger patients were searching for information on diseases (p < .001; M = 35.7 ±13.2), psychiatrists (p < .001; M = 34.6 ±11.6) and exchange with other patients (p < .001; M = 32 ±10.6) more often than older patients. We also found the internet was consulted more often regarding the search for information (p = .011; M = 58.3 ±10.9) and psychiatrists (p < .001; M = 35.7 ±13.2) the lower the patients' level of functioning was. While only a small proportion (10.1%) of the sample had used online self-management interventions before, there is a far greater number (46.1%) who stated an interest to use online self-management interventions in the future. This interest was greater in patients who were younger (p < .001; M = 33.8 ±13.2) had a higher education level (p = .003; university degree = 59.2%, high school degree = 52.3%; mandatory school degree: 34.8%). CONCLUSIONS: While only a small percentage of patients uses online self-management interventions, there is a far greater interest to include them into the treatment. Further research has to investigate how the integration of web-based services into the whole treatment process can be optimized. In addition, standardized diagnostic methods have to be found to evaluate the needs and experiences of patients.